Administered by University of Maine System Office of Strategic Procurement Request for Proposal (RFP)

Transcription

1 Administered by University of Maine System Office of Strategic Procurement Request for Proposal (RFP) Electronic Medical Record (EMR) Cloud Solution RFP # Issued Date: May 3, 2016 Response Deadline Date/Time: May 20, 2016 at 2:00 p.m. EST Response Submission Information: Submitted electronically to Subject Line Electronic Medical Record (EMR) Cloud Solution RFP# Response Contact Information: Strategic Sourcing Manager: Robin Cyr Phone: (207)

2 Contents 1.0 INTRODUCTION Definitions, Background, Purpose and Specifications General Information General Submission Provisions EVALUATION AND AWARD PROCESS Evaluation Criteria Award Negotiations Award Protest RESPONSE FORMAT REQUIREMENTS General Format Instructions Response Format Instructions APPENDICES Appendix A University of Maine System Response Cover Page Appendix B Debarment, Performance and Non-Collusion Certification Appendix C Required Cost Evaluation Exhibits Appendix D Economic Impact Evaluation Form Appendix E Contract for Services Appendix F Certificate of Insurability Form Appendix G Organization Reference Form Appendix H-1 Evaluation Question(s) - Organization, Qualifications and Experience Appendix H-2 Evaluation Matrix(s) Solution Requirements Appendix I Evaluation Question(s) General, Implementation, Training and Support Appendix J Evaluation - Accessibility Requirements Appendix K Evaluation Question(s) Information Security Appendix L Evaluation Question(s) - Information Security Data Elements Checklist Appendix M Evaluation Question(s) - Information Technology Appendix N Interface Data Exchange Requirements University of Maine System RFP P a g e 2 o f 67

3 1.0 INTRODUCTION 1.1 Definitions, Background, Purpose and Specifications Definitions The University of Maine System will hereinafter be referred to as the "University." Respondents to the document shall be referred to as "Respondent(s) or Respondent. The Respondent to whom the Agreement is awarded shall be referred to as the "Contractor." The University of Maine System and other components of the University shall be referred to as Multi-Institution Background Currently, within individual university campuses, UMS is supporting multiple, separate server-based EMRs for Health, Counseling and Athletic Training departments. We are seeking the ability to use a single, cloudbased system that holds the capacity to serve the three disciplines at multiple locations within the UMS system. Ultimately, this enhances our system integration and provides a better service to our students. The EMR must have the capacity to interface with the following programs: UMS Mainestreet Quest Labs Care 360 Program (Health) CCAPS (Counseling) Privit - Student Health Profile (Athletic Training) Purpose The University of Maine System is seeking responses to implement Electronic Medical Record (EMR) Cloud Solution that has the capacity to accommodate health, counseling and athletic training services for appropriate UMS departments/entities, as defined in this document. This document provides instructions for submitting responses, the procedure and criteria by which the Respondent(s) will be selected, and the contractual terms which will govern the relationship between the University and the awarded Respondent(s). Respondents should review Specifications / Scope of Work of this document to see the full Scope of Services/Products required. All campuses in the University of Maine System must be afforded the use of this solution, with all the same terms and conditions applicable to the various University locations. University of Maine System RFP P a g e 3 o f 67

4 1.1.4 Specifications / Scope of Work University of Maine Systems is releasing this RFP for the procurement of a collegiate healthcare information management system. This system will ideally be cloud-based and inclusive of electronic health records for medical, counseling and athletic training services as well as practice management, and revenue cycle management. UMS is seeking responses for a fully integrated system from which care coordination efforts can be maximized, sustainability efforts can be realized and quality improvement efforts can be driven. UMS is interested in obtaining bids for the following user combinations: Health Services Health and Counseling Services Health and Athletic Training Services Health, Counseling and Athletic Training Services. Bidders are requested to address the following EMR system elements in their proposal: Information security features including HIPAA/FERPA compliance and internal/external record-sharing Ability to support separate secure charts of Athletics, Counseling and Health Clinical templates designed for Athletics, Counseling and Health Ability to create counseling charts that are available to select users in Counseling and Health Ability to switch templates after note started and ability to add multiple template sections to note in progress College health specific patient handouts and education tools CCAPs capability E+M coding capability Electronic billing features (link student bills to existing university billing systems?) (complete SHIP and third party billing functionality?) Automated data transfer with campus SIS Paperless immunization compliance tracking Mass vaccination tool [flu shot clinic] Built-in image scanning support Secure messaging to patients and staff Scheduling function Mobile enabled patient portal and intake features: online pre-visit questionnaires; students update records; schedule appointments. Send out appointment reminders to students Self check-in availability Dispensary Model for dispensing medications and supplies in Health Services eprescribing of controlled substances Support mobile devices and wireless deployments Remote access for all permissioned users University of Maine System RFP P a g e 4 o f 67

5 Data reports and analysis Functionality and ease of use Ability to add new users as needed, including temporary student learners Training overview Access to technical support Client Portal: training videos, webinars, documentation Cost: initial and ongoing 1.2 General Information Contract Administration and Conditions The winning Respondent will be required to execute a contract in the form of a University of Maine System Contract for Services, which is attached to this response as Appendix E. Contract initial term and renewal periods are reflected in Section 2 of Appendix E, Contract for Services, and are subject to continued availability of funding and satisfactory performance. The Agreement entered into by the parties shall consist of the University of Maine System Contract for Services (attached to this document), the RFP, the selected Respondent s submission, including all appendices or attachments and clarifications, the specifications including all modifications thereof, and a Purchase Order or Letter of Agreement requiring signatures of the University and the Contractor, all of which shall be referred to collectively as the Agreement Documents. In the event of a conflict of terms the following precedence will apply: 1. University of Maine System Contract for Services 2. Agreement Riders as required 3. Contract Amendments (as required) 4. The University s RFP 5. Respondent s Submission 6. Purchase Order or Letter of Agreement Modification of Agreement terms and conditions is permitted except that the University, due to its public nature, will not : a. Provide any defense, hold harmless or indemnity; b. Waive any statutory or constitutional immunity; c. Apply the law of a state other than Maine; d. Procure types or amounts of insurance beyond those UMS already maintains or waive any rights of subrogation. e. Add any entity as an additional insured to UMS policies of insurance; f. Pay attorneys' fees, costs, expenses or liquidated damages; University of Maine System RFP P a g e 5 o f 67

6 g. Promise confidentiality in a manner contrary to Maine's Freedom of Access Act; h. Permit an entity to change unilaterally any term or condition once the contract is signed; or i. Agree to automatic renewals for term(s) greater than month-to-month By submitting a response to a Request for Proposal, bid or other offer to do business with the University your entity understands and agrees that: a. The above Agreement provisions (Section ) will not be modified and are thereby incorporated into any agreement entered into between University and your entity; that such terms and condition shall control in the event of any conflict with such agreement; and that your entity will not propose or demand any contrary terms; b. The above Agreement provisions (Section ) will govern the interpretation of such agreement notwithstanding the expression of any other term and/or condition to the contrary; c. Your entity agrees that the resulting Agreement will be the entire agreement between the University (including University s employees and other End Users) and Respondent and in the event that the Respondent requires terms of use agreements or other agreements, policies or understanding, whether on an order form, invoice, website, electronic, click-through, verbal or in writing, with University s employees or other End Users, such agreements shall be null, void and without effect, and the terms of the Agreement shall apply. d. Your entity will identify at the time of submission which, if any, portion or your submitted materials are entitled to ''trade secret" exemption from disclosure under Maine's Freedom of Access Act; that failure to so identify will authorize UMS to conclude that no portions are so exempt; and that your entity will defend, indemnify and hold harmless UMS in any and all legal actions that seek to compel UMS to disclose under Maine's Freedom of Access Act some or all of your submitted materials and/or contract, if any, executed between UMS and your entity Communication with the University It is the responsibility of the Respondent to inquire about any requirement of this document that is not understood. Responses to inquiries, if they change or clarify the document in a substantial manner, will be forwarded by addenda to all parties that have received a copy of the document. Addenda will also be posted on our web site, University of Maine System RFP P a g e 6 o f 67

7 It is the responsibility of all Respondents to check the web site before submitting a response to ensure that they have all pertinent documents. The University will not be bound by oral responses to inquiries or written responses other than addenda. Inquiries must be made using the Response Contact Information provided on the cover sheet of this document. Refer to table in Section Timeline of Key Events for deadline requirements Confidentiality The information contained in responses submitted for the University's consideration will be held in confidence until all evaluations are concluded and a Respondent selected (the successful Respondent). At that time the University will issue award notice letters to all participating Respondents and the successful Respondent's response may be made available to participating Respondents upon request. Such request will be made by submitting a written request to the individual noted in the Response Contact Information shown on the cover sheet of this document, with a copy of the request to the successful Respondent. After the protest period has passed and the Agreement is fully executed, the winning response will be available for public inspection. Pricing and other information that is an integral part of the offer cannot be considered confidential after an award has been made. The University will honor requests for confidentiality for information of a proprietary nature to the extent allowed by law. Clearly mark any portion of your submitted materials which are entitled to trade secret exemption from disclosure under Maine's Freedom of Access Act. Failure to so identify as trade secret will authorize the University to conclude that no portions are so exempt; and that your entity will defend, indemnify and hold harmless the University in any and all legal actions that seek to compel the University to disclose under Maine's Freedom of Access Act some or all of your submitted materials and/or contract, if any, executed between the University and your entity. The University must adhere to the provisions of the Maine Freedom of Access Act (FOAA), 1 MRSA 401 et seq. As a condition of submitting a response under this section, a respondent must accept that, to the extent required by the Maine FOAA, responses to this solicitation, and any ensuing contractual documents, are considered public records and therefore are subject to freedom of access requests Costs of Preparation Respondent assumes all costs of preparation of the response and any presentations necessary to the response process. University of Maine System RFP P a g e 7 o f 67

8 1.2.5 Authorization Any Agreement for services that will, or may, result in the expenditure by the University of $50,000 or more must be approved in writing by the Office of Strategic Procurement, Chief Procurement Officer and it is not approved, valid or effective until such written approval is granted Multi-Institutional The University of Maine System, Office of Strategic Procurement reserves the right to authorize other University Institutions to use the Agreement(s) resulting from this document, if it is deemed to be beneficial for the University to do so Pricing All prices provided shall remain firm for the entire term of the agreement Cost Response Form Quantities The quantities shown on the cost response form are approximate only. The Contractor shall cover the actual needs of the University throughout the term of the Agreement regardless of whether they are more or less than the quantities shown Employees The Contractor shall employ only competent and satisfactory personnel and shall provide a sufficient number of employees to perform the required services efficiently and in a manner satisfactory to the University. If the Agreement Administrator or designee, notifies the Contractor in writing that any person employed on this Agreement is incompetent, disorderly, or otherwise unsatisfactory, such person shall not again be employed in the execution of this Agreement without the prior written consent of the Agreement Administrator Environment Compliance In the event that the resulting Agreement involves the generation, transportation, handling, disposal, and/or other operations or activities in relation to toxic, hazardous, radioactive, or otherwise dangerous gases, vapors, fumes, acids, alkali s, chemicals, wastes or contaminants and/or other substance, material or condition, the Contractor agrees to indemnify save harmless and defend the University from and against all liabilities, claims, damages, forfeitures, suits, and the costs and expenses incident thereto (including costs of defense, settlement and reasonable attorney s fees) which the University may hereafter incur as a result of death or bodily injuries or damage to any property, contamination of or adverse effects of the environment or any violation of state or federal regulations or laws (including without limitation the Resources Conservation and Recovery Act, the Hazardous Material Transportation Act or the Superfund Amendment and Reauthorization Act, as the same now exists or may hereafter be amended) or order based on or arising in whole or in part from University of Maine System RFP P a g e 8 o f 67

9 the Contractor s performance under the Agreement, provided, however the Contractor shall not indemnify the University for any liabilities, claims, damages, (as set forth above) caused by or arising out of the sole negligence of the University, or arising out of any area of responsibility not attributable to Contractor. 1.3 General Submission Provisions Timeline of Key Events Reference Section Section Section Section Section Section 2.2 Event Name Deadline for Written Inquiries/Questions Response to Written Inquiries/Questions Deadline for Proposal Submission Estimated Respondent Presentation Date (subject to change) Award Announcement (subject to change) Estimated Agreement Start Date (subject to change) Event Due Date May 11, 2016 May 13, 2016 May 20, 2016 at 2:00 p.m. EST May 25 26, 2016 June 1, 2016 June 13, Eligibility to Submit Responses Public entities, private for-profit companies, and non-profit companies and institutions are invited to submit a response to this document Debarment Respondents must complete and submit the Debarment, Performance and Non-Collusion Certification Form provided in Appendix B. Failure to provide this certification may result in the disqualification of the Respondent s proposal, at the University s discretion. Submission of a signed response in response to this solicitation is certification that your firm (or any subcontractor) is not currently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from participation in this transaction by any State or Federal department or agency. Submission is also agreement that the University will be notified of any change in this status Response Understanding By submitting a response, the Respondent agrees and assures that the specifications are adequate, and the Respondent accepts the terms and conditions herein. Any exceptions should be noted in your response. University of Maine System RFP P a g e 9 o f 67

10 1.3.5 Response Validity Unless specified otherwise, all responses shall be valid for ninety (90) days from the due date of the response Non-Response Submission The University will not consider non-responsive submissions, i.e., those with material deficiencies, omissions, errors or inconsistencies or that otherwise do not follow instructions. The University in its sole discretion will determine what is Non-Responsive Respondents Presentations Presentations may be requested of two or more Respondents deemed by the University to be the best suited among those submitting responses on the basis of the selection criteria. After presentations have been conducted, the University may select the Respondent(s) which, in its opinion, has made the response that is the most responsive and most responsible and may award the Agreement to that/those Respondent(s) Response Submission A SIGNED virus-free electronic copy must be submitted as follows: The response must be received electronically to the shown in the Response Submission Information section of the cover page of this document. Electronic submission must be received by the required Response Deadline Date/Time reflected on the cover page of this document. Response submissions that exceed 20 MB will be submitted with multiple s modifying subject line shown in the Response Submission Information section of the cover page of this document to include: Submission 1 of X ( X representing the number of files being submitted). University of Maine System RFP P a g e 10 o f 67

11 2.0 EVALUATION AND AWARD PROCESS 2.1 Evaluation Criteria Scoring Weights The score will be based on a 100 point scale and will measure the degree to which each response meets the following criteria: Evaluation Category Points Appendices Appendix C Cost Evaluation 20 Appendix D Economic Impact 5 Appendix E Contract for Services 10 Appendix G Organization References 10 Appendix H-1 Organization Qualifications and Experience 15 Appendix H-2 Solution Requirements Matrix 15 Appendix I Implementation, Training and Support 10 Appendix J Accessibility Pass/Fail Appendix K & L Information Technology Security Pass/Fail Appendix M & N Information Technology 15 Total Points Scoring Section Descriptions Cost Evaluation The total cost proposed for conducting all the functions specified in this document will be assigned a score according to a mathematical formula. The lowest cost response will be awarded the total points. Responses with higher cost response values will be awarded proportionately fewer points calculated in comparison with the lowest cost response. The scoring formula is: (Lowest submitted cost response / cost of response being scored) x (20) = pro-rated score The University will NOT seek a best and final offer (BAFO) from any Respondent in this procurement process. All Respondents are expected to provide their best value pricing with the submission of their response. Respondents will NOT be given another opportunity to modify pricing once submitted Economic Impact Using the form in Appendix D (Economic Impact Evaluation Form), the Respondent (Respondent identified on the Response Cover Page of their submission) is required to describe the Respondent s recent and anticipated economic impact upon and within the State of Maine. University of Maine System RFP P a g e 11 o f 67

12 The Economic Impact for this RFP will be assigned a score according to a mathematical formula. Recent Economic Impact: The highest recent economic impact will be awarded 5 points. Proposals with lower recent economic impact will be awarded proportionately fewer points calculated in comparison with the highest impact. The Recent Economic Impact scoring formula is: (Recent Economic Impact proposal being scored / Highest submitted recent Economic Impact proposal) x 10 = pro-rated score Projected Economic Impact*: The highest projected economic impact will be awarded 5 points. Proposals with lower projected economic impact will be awarded proportionately fewer points calculated in comparison with the highest projected economic impact. The Projected Economic Impact scoring formula is: (Projected Economic Impact proposal being scored / Highest submitted projected Economic Impact proposal) x 5 = pro-rated score *Projected Economic Impact is to be based solely on the resulting contract should the Respondent be awarded the contract for these services (See Appendix D for a more detailed explanation). Please note: If the University determines that the Respondent s recent and/or projected economic impact information is deemed to be substantially inaccurate, then the University may determine to not award any points for economic impact to that Respondent for the applicable section(s) Contract for Services Responses which indicate full acceptance of the terms and conditions will receive the total points noted in the table above. Responses with language adjustments, will have point reductions based on University risk assessment. Refer to Agreement provisions detailed in Section for additional guidance Organization Reference(s) The evaluation team will use a consensus approach to evaluate and assign evaluation points. Reference checks will be performed on the top Respondent(s) only as determined by consensus scoring in the other categories. University of Maine System RFP P a g e 12 o f 67

13 Organization, Qualifications and Experience The evaluation team will use a consensus approach to evaluate and assign evaluation points Solution Requirements Matrix As part of the design of the RFP the evaluation team has assigned a weighted score for each requirement detailed in the document. The final score will be assigned based on a mathematical formula The scoring formula is: (Total Respondent Points / Total Possible Matrix Points) x (Maximum Score) = pro-rated score General, Implementation, Training and Support The evaluation team will use a consensus approach to evaluate and assign evaluation points Information Technology Security The evaluation team will use a consensus approach to evaluate and assign evaluation based on pass/fail decision Accessibility The evaluation team will use a consensus approach to evaluate and assign evaluation based on pass/fail decision Information Technology The evaluation team will use a consensus approach to evaluate and assign evaluation points. 2.2 Award While the University prefers a single solution that is scalable to meet the needs of both large and small institutions, it reserves the right to award Agreement(s) to one or multiple Respondents, which may include awards to Respondents for a geographical area, if such award is in the best interest of the University. The University reserves the right to waive minor irregularities, which may include contacting the Respondent to resolve the irregularity. Scholarships, donations, or gifts to the University, will not be considered in the evaluation of responses. The University reserves the right to reject any or all responses, in whole or in part, and is not necessarily bound to accept the lowest cost response if that response is contrary to the best interests of the University. The University may cancel this University of Maine System RFP P a g e 13 o f 67

14 request or reject any or all responses in whole or in part. Should the University determine in its sole discretion that only one Respondent is fully qualified, or that one Respondent is clearly more qualified than any other under consideration, an Agreement may be awarded to that Respondent without further action. 2.3 Negotiations The University reserves the right to negotiate with the successful Respondent to finalize a contract. Such negotiations may not significantly vary the content, nature or requirements of the proposal or the University s Request for Proposals to an extent that may affect the price of goods or services requested. The University reserves the right to terminate contract negotiations with a selected respondent who submits a proposed contract significantly different from the response they submitted in response to the advertised RFP. In the event that an acceptable contract cannot be negotiated with the highest ranked Respondent, the University may withdraw its award and negotiate with the next-highest ranked Respondent, and so on, until an acceptable contract has been finalized. Alternatively, the University may cancel the RFP, at its sole discretion. 2.4 Award Protest Respondents may appeal the award decision by submitting a written protest to the University of Maine System s Chief Procurement Officer within five (5) business days of the date of the award notice, with a copy of the protest to the successful Respondent. The protest must contain a statement of the basis for the challenge. If this RFP results in the creation of a pre-qualified or pre-approved list of vendors, then the appeal procedures mentioned above are available upon the original determination of that vendor list, but not during subsequent competitive procedures involving only the pre-qualified or pre-approved list participants. University of Maine System RFP P a g e 14 o f 67

15 3.0 RESPONSE FORMAT REQUIREMENTS 3.1 General Format Instructions Electronic Submissions Documents submitted as part of the electronic response are to be prepared on standard electronic formats of 8-1/2 x 11 and of PDF file type. Submissions requiring additional supporting information, such as, foldouts containing charts, spreadsheets, and oversize exhibits are permissible and must be submitted as Appendices, clearly numbered and referencing the Section in which they provide supporting information. For clarity, the Respondent s name should appear on every document page, including Appendices. Each Appendix must reference the section or subsection number to which it corresponds Respondents Responsibility It is the responsibility of the Respondent to provide all information requested in the document package at the time of submission. Failure to provide information requested in this document may, at the discretion of the University s evaluation review team, result in a lower rating for the incomplete sections and may result in the response being disqualified for consideration. Include any forms provided in the application package or reproduce those forms as closely as possible. All information should be presented in the same order and format as described in this document Brief Response Respondents are asked to be brief and to respond to each question listed in the Response to Questions section of this document. Number each response in the response to correspond to the relevant question in this document Additional Attachments Prohibited The Respondent may not provide additional attachments beyond those specified in the document for the purpose of extending their response. Any material exceeding the response limit will not be considered in rating the response and will not be returned. Respondents shall not include brochures or other promotional material with their response. Additional materials will not be considered part of the response and will not be evaluated. 3.2 Response Format Instructions This section contains instructions for Respondents to use in preparing their response. The Respondent s submission must follow the outline used below, including the numbering of section and sub-section headings. Failure to use the outline specified in this section or to respond to all questions and instructions throughout this document may result in the response being disqualified as nonresponsive or receiving a reduced score. University of Maine System RFP P a g e 15 o f 67

16 The University and its evaluation team for this document have sole discretion to determine whether a variance from the document specifications should result in either disqualification or reduction in scoring of a response. Re-phrasing of the content provided in this document will, at best, be considered minimally responsive. The University seeks detailed yet succinct responses that demonstrate the Respondent s experience and ability to perform the requirements specified throughout this document Section 1 - Response Cover Page Label this response - Section 1 UMS Response Cover Page Insert Appendix A University of Maine System Response Cover Page Section 2 - Cost Response Label this response - Section 2 Cost Evaluation Insert Appendix C Required Cost Evaluation Exhibits Section 3 Response to Economic Impact Label this response - Section 3 Economic Impact Evaluation Insert Appendix D Economic Impact Evaluation Form Section 4 - Contract for Services Label this response - Section 4 Contract for Services Insert Appendix E Contract for Services Insert Appendix F Certificate of Insurability Form Section 5 - Response to Questions Label this response - Section 5 Response to Evaluation Questions & Related Information Insert Appendix B Debarment, Performance and Non- Collusion Certification Insert Appendix G Organization Reference Form Insert Appendix H-1 Evaluation Question(s) - Organization, Qualifications and Experience Insert Appendix H-2 Evaluation Question(s) Solution Requirements Insert Appendix I Evaluation Question(s) Implementation, Training and Support Insert Appendix J Evaluation Accessibility Requirements Voluntary Product Accessibility Template (VPAT) Detailed Description of Accessibility features Insert Appendix K Evaluation Question(s) Information Technology Security Insert Appendix L Evaluation Question(s) Information Security Data Elements Checklist University of Maine System RFP P a g e 16 o f 67

17 Insert Appendix M Evaluation Question(s) Information Technology 4.0 APPENDICES 4.1 Appendix A University of Maine System Response Cover Page 4.2 Appendix B Debarment, Performance and Non-Collusion Certification 4.3 Appendix C Required Cost Evaluation Exhibits 4.4 Appendix D Economic Impact Evaluation Form 4.5 Appendix E Contract for Services 4.6 Appendix F Certificate of Insurability Form 4.7 Appendix G Organization Reference Form 4.8 Appendix H-1 Evaluation Question(s) - Organization, Qualifications and Experience 4.9 Appendix H-2 Evaluation Question(s) Solution Requirements 4.10 Appendix I Evaluation Question(s) General, Implementation, Training and Support 4.11 Appendix J Evaluation Accessibility Requirements 4.12 Appendix K Evaluation Question(s) - Information Technology Security 4.13 Appendix L Evaluation Question(s) - Information Security Data Elements Checklist 4.14 Appendix M Evaluation Question(s) - Information Technology 4.15 Appendix N Interface Data Exchange Requirements University of Maine System RFP P a g e 17 o f 67

18 Appendix A University of Maine System Response Cover Page Organization Name: Chief Executive Name/Title: Telephone: Fax: Headquarters Street Address: Headquarters City/State/Zip: Lead Point of Contact for Quote Name/Title: Telephone: Fax: Street Address: City/State/Zip: RFP # Electronic Medical Record (EMR) Cloud Solution 1. This pricing structure contained herein will remain firm for a period of 90 days from the date and time of the quote deadline date. 2. No personnel currently employed by the University or any other University agency participated, either directly or indirectly, in any activities relating to the preparation of the Respondent s response. 3. No attempt has been made or will be made by the Respondent to induce any other person or firm to submit or not to submit a response. 4. The undersigned is authorized to enter into contractual obligations on behalf of the above-named organization. 5. By submitting a response to a Request for Proposal, bid or other offer to do business with the University your entity understands and agrees that: a. The Agreement provisions in Section of this document will not be modified and are thereby incorporated into any agreement entered into between University and your entity; that such terms and condition shall control in the event of any conflict with such agreement; and that your entity will not propose or demand any contrary terms; b. The above Agreement provisions in Section of this document will govern the interpretation of such agreement notwithstanding the expression of any other term and/or condition to the contrary; c. Your entity agrees that the resulting Agreement will be the entire agreement between the University (including University s employees and other End Users) and Respondent and in the event that the Respondent requires terms of use agreements or other agreements, policies or understanding, whether on an order form, invoice, website, electronic, click-through, verbal or in writing, with University s employees or other End Users, such agreements shall be null, void and without effect, and the terms of the Agreement shall apply. d. Your entity will identify at the time of submission which, if any, portion or your submitted materials are entitled to ''trade secret" exemption from disclosure under Maine's Freedom of Access Act; that failure to so identify will authorize UMS to conclude that no portions are so exempt; and that your entity will defend, indemnify and hold harmless UMS in any and all legal actions that seek to compel UMS to disclose under Maine's Freedom of Access Act some or all of your submitted materials and/or contract, if any, executed between UMS and your entity. University of Maine System RFP P a g e 18 o f 67

19 Continued - Appendix A University of Maine System Response Cover Page To the best of my knowledge all information provided in the enclosed response, both programmatic and financial, is complete and accurate at the time of submission. Date: Name and Title (Printed) Authorized Signature University of Maine System RFP P a g e 19 o f 67

20 Appendix B Debarment, Performance and Non-Collusion Certification University of Maine System DEBARMENT, PERFORMANCE and NON-COLLUSION CERTIFICATION RFP # Electronic Medical Record (EMR) Cloud Solution By signing this document, I certify to the best of my knowledge and belief that the aforementioned organization, its principals and any subcontractors named in this proposal: a. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from bidding or working on contracts issued by any governmental agency. b. Have not within three years of submitting the proposal for this contract been convicted of or had a civil judgment rendered against them for: i. Fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a federal, state or local government transaction or contract. ii. Violating Federal or State antitrust statutes or committing embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; iii. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or Local) with commission of any of the offenses enumerated in paragraph (b) of this certification; and iv. Have not within a three (3) year period preceding this proposal had one or more federal, state or local government transactions terminated for cause or default. c. Have not entered into a prior understanding, agreement, or connection with any corporation, firm, or person submitting a response for the same materials, supplies, equipment, or services and this proposal is in all respects fair and without collusion or fraud. The above mentioned entities understand and agree that collusive bidding is a violation of state and federal law and can result in fines, prison sentences, and civil damage awards. Failure to provide this certification may result in the disqualification of the Respondent s proposal, at the University s discretion. Date: Name and Title (Printed) Authorized Signature University of Maine System RFP P a g e 20 o f 67

21 Appendix C Required Cost Evaluation Exhibits University of Maine System COST EVALUATION RFP # Electronic Medical Record (EMR) Cloud Solution Respondent s Organization Name: GENERAL INSTRUCTIONS: 1. The Respondent must submit a cost response that covers the entire period of the Agreement, including any optional renewal periods. 2. The cost response shall include the costs necessary for the Respondent to fully comply with the Agreement terms and conditions and requirements. Note regarding total cost of ownership: This cost will encompass the entire solution pricing along with all products and services offered as part of the solution. 3. Failure to provide the requested information and to follow the required cost response format provided in Appendix C may result in the exclusion of the Response from consideration, at the discretion of the University. You can add rows and columns required to insert additional information. If a particular cost table is not required as part of your response simply leave it blank. 4. No costs related to the preparation of the Response for this document or to the negotiation of the Agreement with the University may be included in the Response. Only costs to be incurred after the Agreement effective date that are specifically related to the implementation or operation of contracted services may be included. 5. Identify all costs by year, to be charged for performing the services necessary to accomplish the objectives of this document. 6. If there are additional options or services that are not included in the offering, they must be identified and itemized as optional and include a description of the product or service and the costs of the option. All items identified in the response (including third party items required) will be considered free add-ons to the proposed solution at the prices included in this response unless expressly stated otherwise. 7. Respondents are encouraged to provide additional price incentives for providing an enterprise solution, multi-year or award of multiple institutions. 8. Pricing will be guaranteed by the vendor for the term of the Agreement. 9. The University will NOT seek a best and final offer (BAFO) from any Respondent in this procurement process. All Respondents are expected to provide their best value pricing with the submission of their response. Respondents will NOT be given another opportunity to modify pricing once submitted. University of Maine System RFP P a g e 21 o f 67

22 INSTRUCTIONS FOR Exhibit 1 (Table 1) - Licensing and Maintenance Agreement Pricing and/or Data Maintenance / Subscription Pricing The University needs to understand the associated lifecycle costs for your proposed system or service. For solution responses that leverage the University s existing hardware and software investments, the Respondent must provide which licenses and maintenance agreements the University needs to maintain. For solution responses that do not leverage the University s existing hardware and software investments, the Respondent must provide what additional equipment, licenses, and maintenance agreements we would need to purchase. IMPORTANT - Respondents are required to provide separate costs for each institution. Respondent s Organization Name Provide the Respondent s Organization Name. University Name Institution name pertaining to the costs related to the solution. Item Description - Provide a brief description of each item the University will need purchase or maintain in order to use your proposed system or service both during and after the period of performance period listed in this document. Initial Cost One Time Licensing Provide any initial one-time costs associated with the solution for original one-time license fees. Initial Cost One Time Training Provide any initial one-time costs associated with the solution for training costs/ Initial Cost One Time Implementation Provide any initial one-time costs associated with the solution for implementation costs. Cost (Year 1 5) - All licensing and maintenance agreement pricing should include rates during the Agreement period, and anticipated future rates. Extended Cost - Total for each line item including initial costs and all Year 1-5 costs. Subtotal Subtotal of the Extended Cost figures. Less Discount Discount offered off the Subtotal figure. Total Subtotal less Discount. Exhibit 1 (Table 1) Respondents will use this attachment to record all costs associated with this section. For a copy of the excel version of Exhibit 1, the contact provided on the Response Contact Information on the cover sheet of this document Respondent's Name: Licensing Maintenance Schedule # Item Description University Name: University of Southern Maine Pricing 1 Health Services 2 Health and Counseling Services 3 Health and Athletic Training Services Health, Counseling and Athletic Training 4 Services Subtotal Less Discount Total Initial Cost "One-Time" Licensing Initial Cost "One-Time" Training Initial Cost "One-Time" Implement Year 1 Cost Year 2 Cost Year 3 Cost Year 4 Cost Year 5 Cost Extended Cost University of Maine System RFP P a g e 22 o f 67

23 INSTRUCTIONS FOR - Exhibit 1 (Table 2) - - Licensing and Maintenance Agreement Pricing and/or Data Maintenance / Subscription Pricing for Medium and Small Campus Implementations Pricing estimates provided in this section is for medium-size and smaller-size campus implementation will be utilized to extrapolate the overall cost value for campuses of this size. These estimates are directly related to the University desire to develop a Master Agreement available to all campuses. This pricing will be included in the Master Agreement to leverage when additional campuses exercise this option. Pricing provided in this section will not be included as part of the cost evaluation outlined in Section 2 of this document. IMPORTANT - Respondents are required to provide separate costs for each institution. Respondent s Organization Name Provide the Respondent s Organization Name. Item Description - Provide a brief description of your product or service. Initial Cost One Time Licensing Provide any initial one-time costs associated with the solution for original one-time license fees. Initial Cost One Time Training Provide any initial one-time costs associated with the solution for training costs/ Initial Cost One Time Implementation Provide any initial one-time costs associated with the solution for implementation costs. Cost (Year 1 5) - All licensing and maintenance agreement pricing should include rates during the Agreement period, and anticipated future rates. Extended Cost - Total for each line item including initial costs and all Year 1-5 costs. Interface Data Exchange All costs associated with establishing the interface to exchange data from the systems noted in Appendix N must be captured here. Subtotal Subtotal of the cost figures for each year. Less Discount Discount offered off the Subtotal figure. Total Subtotal less Discount. Exhibit 1 (Table 5) Respondents will use this attachment to record all costs associated with this section. For a copy of the excel version of Exhibit 1, the contact provided on the Response Contact Information on the cover sheet of this document University of Maine System RFP P a g e 23 o f 67

24 Respondent's Name: # Item Description Medium Size Campus Imnplementation Estimate 1 Health Services 2 Health and Counseling Services 3 Health and Athletic Training Services Health, Counseling and Athletic 4 Training Services Interface Data Exchange 5 PRIVIT Profile 6 Quest Diagnostics Counseling Center Assessment of 7 Psychological Symptoms (CCAPS) 8 Physician Billing & Consulting PeopleSoft Campus Solutions 9 (MaineStreet) Subtotal Less Discount Total Respondent's Name: # Item Description Small Size Campus Implementation Estimate 1 Health Services 2 Health and Counseling Services 3 Health and Athletic Training Services Health, Counseling and Athletic 4 Training Services Interface Data Exchange 5 PRIVIT Profile 6 Quest Diagnostics Counseling Center Assessment of 7 Psychological Symptoms (CCAPS) 8 Physician Billing & Consulting PeopleSoft Campus Solutions 9 (MaineStreet) Subtotal Less Discount Total Initial Cost "One- Time" Licensing Initial Cost "One- Time" Licensing Initial Cost "One- Time" Training Initial Cost "One- Time" Training Initial Cost "One- Time" Impleme nt Initial Cost "One- Time" Impleme nt Year 1 Cost Year 1 Cost Licensing Maintenance Schedule Year 2 Cost Year 2 Cost Year 3 Cost Year 3 Cost Year 4 Cost Licensing Maintenance Schedule Year 4 Cost Year 5 Cost Year 5 Cost Extended Cost Extended Cost University of Maine System RFP P a g e 24 o f 67

25 INSTRUCTIONS FOR - Exhibit 1 (Table 3) - Professional Services Rate Schedule If you charge by the hour for professional services, provide a rate schedule, or range of hourly rates we could expect. Specify whether or not those rates include travel. Respondent s Organization Name Provide the Respondent s Organization Name. Role/Position Title if Individual - List role/position title of each role/position title from your organization that would be responsible for work on the project. Hourly Rate - Is the hourly dollar amount that may be invoiced by role/position title. Exhibit 1 (Table 3) Respondents will use this attachment to record all costs associated with this section. For a copy of the excel version of Exhibit 1, the contact provided on the Response Contact Information on the cover sheet of this document Respondent's Name: # Role of Individual/Position Title Hourly Rate Include additional explanation of costs and list assumptions that could influence the cost of change request pricing. List explanations and assumptions here; - - University of Maine System RFP P a g e 25 o f 67

26 INSTRUCTIONS FOR - Exhibit 1 (Table 4) - Pricing for Custom Features Deliverables Provide rate schedule for the high-level deliverables defined RFP Section 2.0 Scope of Work. Costs for subcontractors are to be broken out separately. Respondent s Organization Name Provide the Respondent s Organization Name. University Name Institution name pertaining to the costs related to the solution. Deliverable Name - Provide a brief name for the deliverable. Role/Position Title (Exhibit 1 Table 4) - List each role/position title from your organization that would be responsible for contributing to completion of the deliverable. Bidder will replace verbiage Position Title 1, etc. with the appropriate actual role/position title in Exhibit 1 (Table 3). Hours Note the total hours that will be required to provide the contribution necessary to complete the deliverable for each role/position title. Hourly Rate - The hourly dollar amount that may be invoiced by role/position title. Cost Estimate Calculation of the (Hours x Hourly Rate = Cost Estimate) Sub-Total Provide a sub-total for each deliverable. Total Total cost for all deliverables to complete the work for the specified University campus. Your list of deliverables should trace back to the objectives and requirements listed in this document. Where a requirement is addressed by your product or service without customization, indicate that under the Explanation and reference the Licensing and Maintenance schedule above. Total compensation for services rendered and deliverables shall include any hourly billing rate and all expected related expenses, both actual and administrative. Less Discount Discount offered off the Subtotal figure. Grand Total Subtotal less Discount. Exhibit 1 (Table 3) Respondents will use this attachment to record all costs associated with this section. For a copy of the excel version of Exhibit 1, the contact provided on the Response Contact Information on the cover sheet of this document University of Maine System RFP P a g e 26 o f 67